Individual provider Active NPI

William A. Gonzalez-Marques, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Kettering, OH
National Provider Identifier
1720328776
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35133507 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 298-3399
Fax
(937) 395-8350
NPI assigned
Feb 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 29220R PR
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 288851 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 18789 PR
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35133507 OH Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 160651 FL

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8849

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 298-3399 ext. 55047

Other practice location 2

3201 SW 15th St
Deerfield Beach, FL 33442-8157
Phone (954) 400-1608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230317000783 FL Practitioner - Pathology 4688929557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Puerto Rico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 548-3639

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.51 of 100Reported as group
Quality
73.46
Improvement activities
40
Cost
73.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
160651FLMDAnatomic Pathology & Clinical Pathology Physician
288851NYMDAnatomic Pathology & Clinical Pathology Physician
35133507OHMDAnatomic Pathology & Clinical Pathology Physician
18789PRMDAnatomic Pathology & Clinical Pathology Physician
29220RPRMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathmed Associates LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 3, 2023 Accepting new patients

Locations

3201 SW 15th St
Deerfield Beach, FL 33442
Phone (954) 246-7625

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1720328776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-298-3399",
            "fax_number": "937-395-8350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-298-3399 x55047",
            "fax_number": "937-395-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 SW 15th St",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334428157",
            "country_code": "US",
            "telephone_number": "954-400-1608",
            "fax_number": "866-262-5507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-MARQUES",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PR",
            "license": "29220R",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "288851",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PR",
            "license": "18789",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35133507",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "160651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.